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Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Occurrence of coagulation factor deficiency in post-tonsillectomy hemorrhage
Michaela Zumtobel1, Klemens Frei
1Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Austria.
Wiener Klinische Wochenschrift
|April 12, 2011
Summary
Post-tonsillectomy bleeding can occur even with normal pre-surgical tests. Investigating individual coagulation factors in patients with recurrent bleeding can identify disorders and guide tailored treatments, reducing complications.
Area of Science:
- Otorhinolaryngology
- Hematology
- Surgical Complications
Background:
- Tonsillectomy is a common ENT procedure with a 1.8% rate of significant postoperative bleeding.
- Routine pre-surgical coagulation tests often do not identify all bleeding risks.
- Recurrent post-tonsillectomy hemorrhage occurred in three patients despite normal initial coagulation screening.
Purpose of the Study:
- To investigate the causes of recurrent post-tonsillectomy hemorrhage in patients with initially normal coagulation parameters.
- To evaluate the utility of single coagulation factor analysis in identifying underlying bleeding disorders.
- To determine if tailored therapy based on factor analysis can effectively manage post-tonsillectomy bleeding.
Main Methods:
- Complete coagulation diagnostics were performed on three patients with recurrent post-tonsillectomy bleeding.
- Single coagulation factor analysis was conducted to identify specific deficiencies.
- Treatment involved the application of coagulation-active plasma based on diagnostic findings.
Main Results:
- Factor XIIa deficiency, reduced factor XIIIa, and von Willebrand disease were identified as causes of recurrent late bleeding.
- Application of coagulation-active plasma successfully stopped recurrent late bleeding.
- Detailed factor analysis revealed specific coagulation disorders missed by routine screening.
Conclusions:
- Routine pre-surgical coagulation screening may not detect all causes of post-tonsillectomy bleeding.
- Investigating individual coagulation factors in cases of recurrent bleeding is crucial for diagnosis.
- Tailored therapy based on specific factor analysis can effectively manage post-tonsillectomy hemorrhage and improve patient outcomes.
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